Typhoid Immunisation

Typhoid fever is caused by a bacterium (germ) called Salmonella typhi. This bacterium may contaminate food or drink in areas of poor sanitation. Symptoms include diarrhoea, high fever, and a serious illness which may last for some time. It is sometimes fatal.

(Note: there are many types of Salmonella bacteria. Most types remain in the gut and cause diarrhoea, often as part of 'food poisoning'. The type called Salmonella typhi can get from the gut into other parts of the body and cause the more serious illness of typhoid fever.)

People with typhoid fever pass out the bacteria with their faeces (motions). Even when symptoms have gone, about 1 in 10 people who have had typhoid fever remain 'carriers'. This means that some bacteria continue to live inside the gut, and you continue to pass out bacteria with your faeces. If hygiene is not good, the bacteria can be passed to others who may then get typhoid fever. About half of carriers become free of the typhoid bacteria within three months, but up to half of carriers continue to pass out typhoid bacteria with their faeces long-term.

The incubation period for the disease is usually 1-3 weeks. So, you do not get symptoms for 1-3 weeks after becoming infected. Around 200 cases are notified in the UK each year. About 8 in 10 of these cases are in people who caught the infection abroad.

Who should be immunised against typhoid?

Travellers to areas where typhoid is a problem should be immunised. Particularly where hygiene and sanitation are poor. The worst affected areas are Asia, Africa, Central and South America. Immunisation may not be needed for short stays to some affected countries if you stay in good accommodation (including most 'package holidays'). Your GP or practice nurse can advise if you should be immunised against typhoid for your travel destination.

People who handle specimens which may contain typhoid bacteria should also be immunised.

The vaccine

A single injection of vaccine gives protection for three years. Ideally you should have an injection at least two weeks before travel to allow immunity to develop. However, the vaccine may still be advised even if there is less than two weeks before you travel. The vaccine stimulates your body to make antibodies against typhoid bacteria. These antibodies protect you from illness should you become infected with typhoid bacteria.

A booster dose is recommended every three years for those still at risk.

A combined vaccine against typhoid fever and hepatitis A is also available. This may be useful if you require protection against both illnesses. The hepatitis A component gives protection for one year and the typhoid component gives protection for three years.

Are there any possible side-effects?

Mild local soreness and redness may occur after the injection, but serious reactions are rare.

Who should not receive typhoid vaccine?

• Pregnant women. The risks are thought to be very small, but as with any other vaccine it is wise to play safe. However, if your risk of exposure to typhoid is high, it may be advisable to be immunised even if you are pregnant.
• If you have an illnesses with fever it is best to wait until the illness has subsided before being immunised.
• Children under the age of 18 months.
• You should not have a booster if you have had a severe reaction to this vaccine in the past.

Other points

Remember - immunisation for travellers is only one aspect of preventing illness. Typhoid vaccine is not 100% effective, particularly if you are exposed to large numbers of typhoid bacteria. So when you travel to 'at risk' areas you should: have good personal hygiene, only drink water or other drinks that are known to be safe (bottled water, sterilised water, etc), and only eat foods that have been cleaned and/or prepared properly.

Further information

Health Advice for Travellers.
All travellers going abroad are advised to get this booklet by the Department of Health. You can get a free copy:

• From main post offices, or
• By writing, phoning, faxing or emailing the Department of Health (allow 10 days to get it).

  Department of Health, PO Box 777, London, SE1 6XH
  Telephone: 08701 555455    Fax: 01623 724524    Email doh@prolog.uk.com

• Or view the content on the web www.dh.gov.uk/PolicyAndGuidance/HealthAdviceForTravellers/fs/en

Immunisation Against Infectious Disease (The Green Book)
www.dh.gov.uk/PolicyAndGuidance/HealthAndSocialCareTopics/GreenBook/fs/en
From the Department of Health. Aimed at health professionals but of interest to all.

Health Information for Overseas Travel (The Yellow Book)
www.archive.official-documents.co.uk/document/doh/hinfo/index.htm
From the Department of Health. Aimed at health professionals but of interest to all.

Information on immunisation
www.immunisation.org.uk
From the NHS aimed at the general public.

Patient UK Travel Health Page
www.patient.co.uk/showdoc/38/
Has a comprehensive list of links to UK websites on travel health.

© EMIS and PIP 2004   Updated: April 2004   Review Date: May 2005   CHIQ Accredited